AMCNO Testifies Before Finance Health & Human Services Subcommittee – AMCNO Members Urged to Contact Legislators

The Academy of Medicine of Cleveland & Northern Ohio (AMCNO) President Dr. James Coviello testified before the Ohio House Finance Subcommittee on Health and Human Services to voice concerns about physician reimbursement changes proposed in the Executive Budget for the Medicaid program. The budget proposed by Gov. John Kasich would eliminate Medicaid’s crossover payment for physician services delivered to dual-eligible (Medicare/Medicaid) patients and use the funds generated by this cut to provide for a small increase in Medicaid physician reimbursement rates for a small set of primary care codes. Additional funding for this reimbursement rate increase would come from a $25 million cut to Medicaid’s direct graduate medical education (GME) payments.  
Dr. Coviello provided the committee with statistics from the Medicaid program which indicated that Medicaid managed care data collected from January to June 2014 showed encouraging trends in terms of shifting the newly-enrolled Medicaid population from uncoordinated, higher-cost care to coordinated, lower-cost care. He also stated that as healthcare reform continues to present physician practices with numerous challenges in adapting to new regulatory requirements, value-based purchasing, and care coordination, physician practices often incur additional costs to succeed in this new environment. In this business model, practice sustainability requires adequate reimbursement for services rendered. Dr. Coviello noted that the Executive Budget proposes to increase the primary care reimbursement rate by $156 million over the next biennium, raising the average Medicaid reimbursement from 59% to 64% of the Medicare reimbursement rate for a limited number of codes. However, the budget proposes to pay for this primary care increase by reducing dual-eligible payments by $129 million and by decreasing funding for physician training. Since many primary care physicians manage Medicare/Medicaid dual-eligible patients, they will essentially receive no meaningful increase in reimbursement under the current budget proposal. In addition, reducing the funding for physician training at a time when more patients are entering the medical system seems counterproductive. To view Dr. Coviello’s testimony click here.

The AMCNO encourages our members to contact their legislators and take action on this important issue. Tell your legislators to eliminate the proposed cuts to dual-eligible and GME payments and to further increase Medicaid physician reimbursement rates to 100% of Medicare rates. As noted in Dr. Coviello’s testimony – physicians should be appropriately reimbursed by Medicaid for the services they provide to Medicaid patients. To find your legislator click here or contact these key Ohio House Representatives who have the ability to impact Medicaid's budget: 

Rep. Robert Sprague, Chair, House Finance Subcommittee on Health: (614) 466-3819

Rep. Emilia Sykes, Ranking Member, House Finance Subcommittee on Health: (614) 466-3100

Rep. Barbara Sears, Chair, Joint Medicaid Oversight Committee: (614) 466-1731

Rep. Mark Romanchuk, Member, House Finance Subcommittee on Health: (614) 466-5802

Rep. Nickie Antonio, Member, House Finance Subcommittee on Health: (614) 466-5921

Rep. Ryan Smith, Chair, House Finance Committee: (614) 466-1366

Rep. Cliff Rosenberger, Speaker of the House: (614) 466-3506

If you get someone on the phone, here's what you can talk about – or feel free to utilize talking points from Dr. Coviello’s testimony:

  • Physicians - both in primary and specialty care - will have to make tough decisions about the number of dual-eligible patients they can see because of this proposal.  There WILL be physicians who decide to limit and eliminate the care they provide to dual-eligibles.
  • The new primary care rates don't do nearly enough to increase access to care for Medicaid patients, and that failing to maintain adequate payment rates (such as those that were in place in 2013-2014) will force physicians to limit the number of Medicaid patients they can take.  We know that 100% of Medicare rates would actually have a positive impact on access.
  • Inflation-adjusted rates for Medicaid physician reimbursement have significantly decreased over the past 10-20 years, while the cost of running a practice has stayed steady with inflation.  This disparity means that continuing to see Medicaid patients at more and more of a loss each year.
  • High-quality physician care for Medicaid patients can save the program from paying for long-term, expensive care in the future.  It is responsible to invest in paying physicians now to prevent costs down the road.

We need your help to prevent harmful cuts to Medicaid's reimbursement of physicians. Take Action Now!

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